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REGISTER.DOC
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1997-07-29
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47 lines
Registration form for Dragon's Den Housing IGM
-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-
Name : ______________________________ Age: ___ (optional)
Handle: ______________________________
Address: ___________________________________________________________
City : _______________________
State or Province: ___ E-mail Address : ________________________________
Zip: _ _ _ _ _ - _ _ _ _ Or _ _ _ -_ _ _ (Canada)
BBS Name: ___________________________ BBS Software: _________________
BBS Phone Number: (___)____-_______ Max baud rate: ______
Home Phone Number: (___)____-______ More then one phone line? [ ] Yes!
($5)Please send my Registered version of Dragon's Den Housing through Email ______
($8)Please send my Registered version of Dragon's Den Housing via US mail _______
($8)Send my Registered version of Dragon's Den Housing via US and E mail _______
Amount of money enclosed for this order (U.S Currency!) : _____
Comments / Suggestions :
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
Send this form with your U.S. funds check or money order to:
Codax Dragon
107 Patti Lane
St. Clairsville, OH 43950